| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
413,351 |
378,934 |
$59.45M |
| 00003 |
Internal/system code - not a standard HCPCS code |
4,661 |
4,168 |
$980K |
| D1120 |
Prophylaxis - child |
84,293 |
66,958 |
$649K |
| D1208 |
Topical application of fluoride, excluding varnish |
85,174 |
67,938 |
$350K |
| D0120 |
Periodic oral evaluation - established patient |
95,492 |
76,467 |
$316K |
| D1351 |
Sealant - per tooth |
64,509 |
19,871 |
$297K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
7,319 |
5,558 |
$270K |
| D0230 |
Intraoral - periapical each additional radiographic image |
389,696 |
70,587 |
$247K |
| D0274 |
Bitewings - four radiographic images |
64,304 |
51,992 |
$224K |
| D0220 |
Intraoral - periapical first radiographic image |
98,471 |
76,009 |
$191K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
21,429 |
15,840 |
$173K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17,826 |
12,553 |
$136K |
| 90832 |
Psychotherapy, 30 minutes with patient |
8,234 |
5,352 |
$120K |
| D1310 |
|
105,072 |
85,303 |
$89K |
| D0170 |
|
7,377 |
5,948 |
$85K |
| G0071 |
Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only |
5,207 |
4,691 |
$78K |
| D0210 |
Intraoral - complete series of radiographic images |
8,060 |
6,205 |
$68K |
| 90791 |
Psychiatric diagnostic evaluation |
2,198 |
1,603 |
$63K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
68,851 |
59,140 |
$47K |
| D1352 |
|
9,626 |
5,600 |
$46K |
| G0466 |
Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
513 |
452 |
$39K |
| D9999 |
Unspecified adjunctive procedure, by report |
1,391 |
1,181 |
$37K |
| D9430 |
|
7,813 |
5,887 |
$35K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
9,002 |
7,848 |
$31K |
| D0603 |
|
37,197 |
30,893 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
38,790 |
32,701 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19,481 |
17,140 |
$15K |
| D7140 |
Extraction, erupted tooth or exposed root |
753 |
342 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,442 |
1,970 |
$8K |
| 0012A |
|
424 |
301 |
$6K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
4,914 |
4,434 |
$6K |
| D0272 |
Bitewings - two radiographic images |
3,799 |
3,295 |
$6K |
| 90834 |
Psychotherapy, 45 minutes with patient |
212 |
129 |
$5K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
512 |
487 |
$5K |
| D0999 |
Unspecified diagnostic procedure, by report |
72 |
72 |
$4K |
| 0011A |
|
507 |
379 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
270 |
236 |
$3K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
339 |
320 |
$3K |
| D1999 |
|
45 |
45 |
$3K |
| D0270 |
|
1,788 |
1,360 |
$3K |
| D1320 |
|
5,752 |
4,952 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
211 |
160 |
$2K |
| D4341 |
|
78 |
28 |
$1K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
284 |
258 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
582 |
532 |
$1K |
| H1001 |
Prenatal care, at-risk enhanced service; antepartum management |
584 |
528 |
$907.20 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
1,040 |
772 |
$831.72 |
| 0031A |
|
86 |
72 |
$804.00 |
| 0064A |
|
55 |
45 |
$761.00 |
| 0002A |
|
58 |
38 |
$737.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,413 |
2,300 |
$684.30 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,830 |
1,751 |
$583.77 |
| D0601 |
|
246 |
208 |
$555.86 |
| 0013A |
|
32 |
26 |
$441.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,027 |
1,946 |
$415.58 |
| 99381 |
|
504 |
485 |
$362.64 |
| 90651 |
|
846 |
817 |
$343.00 |
| 0001A |
|
20 |
16 |
$294.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
762 |
748 |
$291.32 |
| 99383 |
|
184 |
179 |
$263.66 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
583 |
413 |
$239.48 |
| 90674 |
|
574 |
522 |
$225.16 |
| 92551 |
|
3,643 |
3,514 |
$186.45 |
| 90686 |
|
3,400 |
3,293 |
$178.28 |
| D0602 |
|
249 |
231 |
$135.00 |
| 90633 |
|
1,460 |
1,416 |
$112.10 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
13 |
$102.90 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,804 |
4,646 |
$82.01 |
| 90715 |
|
281 |
271 |
$78.00 |
| 90833 |
Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) |
1,136 |
867 |
$68.98 |
| 85018 |
|
2,249 |
2,176 |
$63.96 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$59.30 |
| 90697 |
|
421 |
404 |
$54.00 |
| 90677 |
|
264 |
235 |
$54.00 |
| 83655 |
|
140 |
123 |
$53.04 |
| 99215 |
Prolong outpt/office vis |
160 |
136 |
$51.35 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,157 |
4,067 |
$44.47 |
| 90710 |
|
697 |
669 |
$36.00 |
| 90707 |
|
223 |
214 |
$27.00 |
| 90700 |
|
508 |
495 |
$27.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,612 |
5,343 |
$25.78 |
| 99422 |
|
108 |
86 |
$22.68 |
| 80305 |
|
113 |
87 |
$20.46 |
| 90734 |
|
428 |
420 |
$18.00 |
| 90680 |
|
656 |
645 |
$18.00 |
| 99173 |
|
3,550 |
3,441 |
$10.89 |
| 90647 |
|
794 |
772 |
$9.00 |
| 97803 |
|
42 |
42 |
$8.41 |
| 99401 |
|
55 |
54 |
$8.41 |
| 96156 |
|
61 |
60 |
$8.41 |
| 90461 |
|
2,725 |
2,664 |
$7.14 |
| 3078F |
|
46,697 |
41,037 |
$0.00 |
| 3050F |
|
7,146 |
6,178 |
$0.00 |
| D9993 |
|
1,739 |
1,727 |
$0.00 |
| 90713 |
|
147 |
143 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
57,194 |
49,637 |
$0.00 |
| Z6500 |
|
1,562 |
1,551 |
$0.00 |
| Z6304 |
|
494 |
486 |
$0.00 |
| 0502F |
|
1,733 |
1,434 |
$0.00 |
| G8753 |
Most recent systolic blood pressure >= 140 mmhg |
11,799 |
9,985 |
$0.00 |
| 4004F |
|
201 |
164 |
$0.00 |
| 3077F |
|
11,770 |
9,963 |
$0.00 |
| Z6400 |
|
2,283 |
2,266 |
$0.00 |
| 90670 |
|
1,856 |
1,834 |
$0.00 |
| 0071A |
|
15 |
15 |
$0.00 |
| 90661 |
|
42 |
42 |
$0.00 |
| 99382 |
|
19 |
19 |
$0.00 |
| 3045F |
|
32 |
32 |
$0.00 |
| 3051F |
|
148 |
142 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
585 |
516 |
$0.00 |
| 3046F |
|
342 |
311 |
$0.00 |
| 90648 |
|
602 |
596 |
$0.00 |
| H1002 |
Prenatal care, at risk enhanced service; care coordination |
74 |
74 |
$0.00 |
| 98940 |
|
190 |
151 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
19 |
14 |
$0.00 |
| 9504 |
Hit antibiotic total diem |
13 |
13 |
$0.00 |
| 81025 |
|
29 |
29 |
$0.00 |
| 99201 |
|
13 |
13 |
$0.00 |
| 91300 |
|
71 |
47 |
$0.00 |
| 80101 |
|
35 |
35 |
$0.00 |
| 82948 |
|
35 |
31 |
$0.00 |
| D1330 |
|
81,328 |
66,931 |
$0.00 |
| 3052F |
|
68 |
65 |
$0.00 |
| 3008F |
|
76,105 |
66,144 |
$0.00 |
| G8755 |
Most recent diastolic blood pressure >= 90 mmhg |
5,799 |
4,907 |
$0.00 |
| 1034F |
|
1,179 |
962 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
62,947 |
54,462 |
$0.00 |
| 2001F |
|
76,120 |
66,156 |
$0.00 |
| 1036F |
|
51,680 |
44,109 |
$0.00 |
| 3079F |
|
18,416 |
15,717 |
$0.00 |
| 3075F |
|
9,048 |
7,753 |
$0.00 |
| Z6406 |
|
483 |
475 |
$0.00 |
| 3074F |
|
49,016 |
42,951 |
$0.00 |
| 3048F |
|
14,133 |
12,086 |
$0.00 |
| 91301 |
|
1,116 |
888 |
$0.00 |
| D4355 |
|
525 |
500 |
$0.00 |
| 3049F |
|
10,049 |
8,684 |
$0.00 |
| Z6410 |
|
3,763 |
2,701 |
$0.00 |
| D4999 |
|
771 |
757 |
$0.00 |
| 3044F |
|
734 |
681 |
$0.00 |
| 90716 |
|
368 |
365 |
$0.00 |
| 90696 |
|
227 |
225 |
$0.00 |
| 90723 |
|
926 |
907 |
$0.00 |
| 3080F |
|
4,604 |
3,896 |
$0.00 |
| D9995 |
|
6,494 |
4,589 |
$0.00 |
| Z6204 |
|
493 |
485 |
$0.00 |
| 90620 |
|
89 |
87 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |
| 1111F |
|
170 |
134 |
$0.00 |
| Z1034 |
|
1,845 |
1,395 |
$0.00 |
| 90656 |
|
64 |
63 |
$0.00 |
| 90744 |
|
28 |
28 |
$0.00 |
| 91307 |
|
34 |
34 |
$0.00 |
| 91303 |
|
74 |
72 |
$0.00 |
| 99384 |
|
41 |
40 |
$0.00 |
| 90619 |
|
56 |
55 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
138 |
129 |
$0.00 |
| D5899 |
|
60 |
39 |
$0.00 |
| 90474 |
|
113 |
111 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
15 |
14 |
$0.00 |
| 9602 |
|
14 |
14 |
$0.00 |
| 93000 |
|
17 |
17 |
$0.00 |
| 99205 |
Prolong outpt/office vis |
20 |
20 |
$0.00 |